DIP MAY 2004

POSTGRADUATE INSTITUTE OF MEDICINE
UNIVERSITY OF COLOMBO
QUALIFYING EXAMINATION FOR DIPLOMA IN VENERELOGY
MAY 2004
Date : 11th May, 2004 Time : 1.30 p.m. – 4.30 p.m.
Answer All Five questions.
Each question in a separate book.
1. In June 2001, United Nations met in a Special Session of the General Assembly and
agreed on comprehensive and coordinated global response to the AIDS crisis. The
UNGASS (Special Session) made a declaration of commitment. One of its targets and
goals included;
"Make treatment and care for people with HIV / AIDS as fundamental to the AIDS
response as is prevention". ie. Equal importance should be given for both care of patients
and prevention.
Comprehensive care for people living with HIVI AIDS involves a number of important
interventions in addition to increased provision of antiretrovirals.
1.1. List five other interventions which will contribute to achieve the
above goal. (25 marks)
1.2 List two important outcomes of provision of antiretrovirals to HIV/ AIDS
patients. (10 marks)
1.3. List five opportunistic infections that could occur in an AIDS
patient during the course of the disease. (25 marks)
1.4. Write a brief account on multisectoral approach to containing the HIV I AIDS
epidemic. Your answer should not be more than one page. (40 marks)
2. As the MOH of an area while going through VDRL reports of antenatal clinic attendees
you find a reactive VDRL result with a titre R (8) and positive TPP A. According to the
area PHM the particular mother had already delivered at a provincial hospital and the
baby is 7 days old. Both mother and baby are doing well at home.
2.1. List the possible reasons for failure to identify this case early. (20 marks)
2.2. How would you manage the mother and the baby as the MOH? (30 marks)
2.3. If you were the MO/IC of the provincial STD clinic how would
you manage the family? (50 marks)
3. Comment on the following statement "In order to control the spread of HIV infection in
Sri Lanka everyone entering the country (both foreigners and Sri Lankans) should be
screened for HIV at the port of entry" .
(100 marks)
4. A 28 year old Business Executive has just returned from Singapore after participating in a
Seminar. On the last day he has had unprotected vaginal and oral sex with a fellow
female participant from China. The following day soon after returning home he has had
unprotected sex with his wife. He is asymptomatic but very worried.
4.1. What information will you seek in the history ? (20 marks)
4.2. What clinical findings would you look for while examining
this patient? (20 marks)
4.3. List the investigations you would carry out. (20 marks)
4.4. What further advice would you give this patient for purposes
of follow up? (40 marks)
5. A 33 year old unmarried sportsman seeks medical attention for lower abdominal pain,
fever and painful swelling of his scrotum.
5.1. What conditions will you consider in your differential diagnosis? (20 marks)
5.2. List the features in the history and examination that would help
you in your differential diagnosis. (30 marks)
5.3. If he has a purulent discharge per urethra or he gives a history of
recent discharge per urethra, in addition to his scrotal swelling,
outline how you would manage this case at a district level hospital
where there is no STD clinic. (50 marks